Health Tip: Using a Food Thermometer

(HealthDay News) -- Using a food thermometer can help ensure that food is cooked properly, reducing your risk of a food-borne illness.

The U.S. Food Safety and Inspection Service offers these suggestions:

Test food with an instant-read thermometer toward the end of its cooking time, but before you expect it to be fully cooked. Place the thermometer in the thickest area of the food, and make sure it is not touching any bone, gristle or fat.Use the U.S. Department of Agriculture's recommended guidelines to make sure your food is cooked to a safe temperature.Always use hot water and soap to wash your thermometer before and after each use.

-- Diana Kohnle
Copyright © 2013 HealthDay. All rights reserved.

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Fraudulent Data May Have Led to Use of Risky Treatment in ICUs

By Amanda Gardner
HealthDay Reporter

TUESDAY, Feb. 19 (HealthDay News) -- Studies loaded with fraudulent data may have encouraged the use of a treatment for patients in intensive care units that now appears to do more harm than good, new research shows.

At issue is hydroxyethyl starch, an intravenous solution sometimes used to replace lost blood volume in critically ill patients. According to a new review article in the Feb. 20 issue of the Journal of the American Medical Association, the starchy solution may instead boost their risk of death or kidney failure.

"Almost certainly, what is happening is that some of the starch molecules leak out of blood vessels into the kidney itself so the kidney doesn't work as efficiently," said Dr. David Taylor, chairman of pulmonary and critical care medicine at Ochsner Health System in New Orleans. He was not involved in the new review.

Luckily for American patients, hydroxyethyl starch is not commonly used in the United States, Taylor said. But the new analysis serves as a cautionary tale on how fraudulent data can end up endangering patients' lives.

As Taylor explained it, critically ill patients often develop leaky vessels, and so quickly require intravenous fluids to keep their blood pressure stable and to improve organ function.

One such fluid is simple saline or salt water, known as crystalloid solution. This is the cheapest fluid available, but it tends to leak out of blood vessels, which means it can also leak into the lungs, under the skin and into various organs.

As a result, researchers have spent considerable time and effort trying to find less leaky alternatives to saline. The protein albumin, derived from human blood, is commonly used after cardiac surgery, when the risk of fluid collecting in the lungs is high, Taylor explained. Although albumin is less leaky than saline, it is more expensive.

Hydroxyethyl starch is similar to albumin, but it contains starch molecules, which are less likely to leak out of the blood vessels than saline.

Still, many researchers had reservations about using a starch-based solution from the beginning, Taylor said.

"If you have salt water and it leaks out, you just get some salt into the tissue and it goes away with a little bit of time," he explained. On the other hand, "if you have starch in the tissue it's not so easy to get starch out of there, and many people were worried about the possibility of complications."

It turns out there was even more reason to be suspicious of any alleged benefits of hydroxyethyl starch. In 2011, investigators discovered that the lion's share of research on the treatment that was conducted by German anesthesiologist Dr. Joachim Boldt was fraudulent and had to be retracted.

So the author of the current paper wondered: Would the purported benefits of hydroxyethyl starch hold up once Boldt's data was excluded?

Led by Dr. Ryan Zarychanski, of the University of Manitoba in Winnipeg, Canada, the team pooled data from 38 previous studies on the issue, including those by Boldt.

That analysis concluded that patients who received hydroxyethyl starch did not fare any better than other types of fluid.

But when the Boldt studies were excluded from the mix, hydroxyethyl starch was actually associated with an increased risk of death, kidney failure and need for dialysis among patients, the new research found.

It's impossible to gauge how many patients were damaged by Boldt's falsified research, but this new study highlights "how the inclusion or exclusion of the Boldt papers associated with research misconduct can shift the balance toward harm," said Dr. Massimo Antonelli, author of an editorial accompanying the new study.

"It showed also how the worldwide administration of starches for volume replacement therapy have caused the increase of acute renal failure and affected mortality," said Antonelli, a professor of intensive care and anesthesiology at the Catholic University-A.Gemelli University Hospital in Rome.

He added that a task force of the Surviving Sepsis Campaign, an organization devoted to reducing death from sepsis, recently issued guidelines warning against using starches for fluid replacement.

"These findings will reinforce [those] recommendations," he said.

Taylor stressed, however, that it would still be helpful to find alternatives to both albumin and saline.

A person in the intensive care unit (ICU) can have 1-2 liters more of fluid going into their body than out, said Taylor. Each liter weighs 1 kilogram, or 2.2 pounds.

"It's possible to gain anywhere from 8-10 pounds in fluid [in the ICU] so it would be a great to have an alternative to 10 pounds of weight," he said. However, a starch solution "is not a good alternative because it increases the risk of dying or needing dialysis," Taylor said.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: David Taylor, M.D., chairman, pulmonary and critical care medicine, Ochsner Health System, New Orleans; Massimo Antonelli, M.D., professor, intensive care and anesthesiology, Catholic University-A. Gemelli University Hospital, Rome; Feb. 20, 2013, Journal of the American Medical Association

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Injuries Rising Among Young Dancers

TUESDAY, Feb. 19 (HealthDay News) -- A new study finds that 113,000 children and teens were treated for injuries related to dancing from 1991 to 2007, and the annual number of injuries grew by more than a third over that period.

Sprains and strains, or both, were most common, causing 52 percent of injuries, followed by falls, responsible for 45 percent of dance-related mishaps.

The study looked at dance injuries among children and young adults aged 3 to 19. All were treated in U.S. emergency rooms.

"Adolescents are still growing into their bodies and as such often develop imbalances that can lead to injury," said Eric Leighton, an athletic trainer in sports medicine at Nationwide Children's Hospital, in a hospital news release. "It's critical that intervention and injury prevention be made available to them to address balance, strength and functional body control deficits as they grow."

According to the study, the annual number of dance-related injuries grew from 6,175 injuries in 1991 to nearly 8,500 injuries in 2007. Forty percent of injuries occurred in dancers aged 15 to 19.

"We believe this could be due to adolescent dancers getting more advanced in their skills, becoming more progressed in their careers and spending more time training and practicing," Kristin Roberts, lead study author and a senior research associate at the Center for Injury Research and Policy at the hospital, said in the news release. "We encourage children to keep dancing and exercising. But it is important that dancers and their instructors take precautions to avoid sustaining injuries."

Senior author Lara McKenzie, principal investigator at the Center for Injury Research and Policy, added: "Safety precautions such as staying well-hydrated, properly warming up and cooling down, concentrating on the proper technique and getting plenty of rest can help prevent dance-related injuries."

The study appears in the February issue of the Journal of Physical Activity and Health.

-- Randy Dotinga
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Nationwide Children's Hospital, news release, Feb. 11, 2013

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As Economy Rebounds, More Folks Try Turning Back Hands of Time

TUESDAY, Feb. 19 (HealthDay News) -- Evidence of the economic upturn can be found in more than housing starts and auto sales: A new report shows that the number of cosmetic procedures grew 5 percent in 2012.

Botox injections and other types of minimally invasive treatments led the way as more people opted for these types of facial rejuvenation procedures, while the number who chose to "go under the knife" remained relatively stable, the findings revealed.

In total, there were 14.6 million minimally invasive and surgical plastic surgery procedures in 2012. There were also 5.6 million reconstructive plastic surgery procedures last year, an increase of 1 percent from 2011, according to annual statistics from the American Society of Plastic Surgeons (ASPS).

Minimally invasive procedures increased 6 percent, with more than 13 million procedures in 2012. The top five were:

There were nearly 1.6 million cosmetic surgical procedures in 2012, a 2 percent decrease from 2011. The top five surgical procedures last year were:

Breast augmentation (286,000 procedures, down 7 percent)Nose reshaping (243,000 procedures, no change)Liposuction (202,000 procedures, down 1 percent)Eyelid surgery (204,000 procedures, up 4 percent)Facelift (126,000 procedures, up 6 percent).

While cosmetic breast surgeries among women decreased 2 percent between 2011 and 2012, male breast reduction surgeries increased 5 percent, to nearly 21,000 in 2012, the report said.

"For the third consecutive year, the overall growth in cosmetic surgery continues to be driven by a significant rise in minimally invasive procedures, while surgical procedures remain relatively stable. We are aware, however, that patients who begin with less-invasive treatments with a plastic surgeon may opt for more invasive, surgical procedures once required," Dr. Gregory Evans, ASPS president, said in a society news release.

Reconstructive plastic surgery increased by 1 percent in 2012 and the top five procedures were:

Tumor removal (4.2 million, up 1 percent)Laceration repair (291,000, down 4 percent)Maxillofacial surgery (209,000, up 7 percent)Scar revision (171,000, down 2 percent)Hand surgery (123,000, up 3 percent).

Reconstructive breast reduction increased 8 percent, with 68,000 procedures performed in 2012, the report noted.

"Although breast reduction has many physical and psychological benefits for women with overly large breasts, obstacles remain in acquiring insurance coverage," Evans said. "It's promising to see gains in this and other beneficial, medically necessary surgeries."

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: American Society of Plastic Surgeons, news release, Feb. 19, 2012

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Drug, Alcohol Abuse More Likely Among High School Dropouts

TUESDAY, Feb. 19 (HealthDay News) -- The link between poor academic performance and substance abuse just got stronger, with a new U.S. government report showing ties between the two.

High school seniors who dropped out of school before graduating were more likely to drink, smoke cigarettes and use marijuana and other illegal drugs, according to a new report from the U.S. Substance Abuse and Mental Health Services Administration.

The researchers said their findings should prompt communities to develop strategies to keep teens in school and prevent problems with substance abuse.

"The fact that nearly one in seven students drops out of high school has enormous public health implications for our nation," SAMHSA Administrator Pamela Hyde said in an agency news release. "Dropouts are at increased risk of substance abuse, which is particularly troubling given that they are also at greater risk of poverty, not having health insurance, and other health problems. We have to do everything we can to keep youth in school so they can go on to lead healthy, productive lives, free from substance abuse."

The study revealed high school seniors (typically between 16 and 18 years of age) who dropped out of school were more than twice as likely to be smokers, or have smoked in the past month, than students who stayed in school. The study also found that more than 31 percent of seniors who didn't receive their diploma used drugs, compared with about 18 percent of students who had finished high school.

The researchers also noted that about 27 percent of high school dropouts smoked marijuana, while close to one in every 10 abused prescription drugs. Meanwhile, only about 15 percent of those who completed high school used marijuana and just 5 percent abused prescription drugs.

Dropouts were also more likely to drink -- the study showed that nearly 42 percent of seniors who didn't finish high school drank and about a third engaged in binge drinking.

In contrast, about 35 percent of those students who stayed in school drank and only about one-quarter said they binged on alcohol.

-- Mary Elizabeth Dallas
Copyright © 2013 HealthDay. All rights reserved. SOURCE: U.S. Substance Abuse and Mental Health Administration, news release, Feb. 14, 2013

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Blame Common Colds on Your Chromosome 'Caps?'

By Amy Norton
HealthDay Reporter

TUESDAY, Feb. 19 (HealthDay News) -- Some people seem to catch a cold every few weeks while others appear immune. Now a preliminary study suggests that the protective "caps" on your chromosomes could partly explain the mystery.

The study, reported in the Feb. 20 issue of the Journal of the American Medical Association, found that healthy young adults were more prone to catching a cold when their immune system cells had relatively short telomeres.

Telomeres are lengths of DNA that sit at the ends of your chromosomes. Think of them like the plastic caps at the ends of a shoelace: Telomeres help keep your chromosomes -- which carry your genes -- from fraying and sticking together.

As people age, their telomeres gradually get shorter, and research has linked shorter telomere length to older adults' risks of developing and dying from infections, cancer and heart disease.

"But there's been very little known about telomere length in young people, certainly in relation to health," said Sheldon Cohen, a professor of psychology at Carnegie Mellon University in Pittsburgh who led the new study.

Because colds and other respiratory infections are the most common health woe in younger people, Cohen's team decided to see whether telomere length mattered in their risk of developing a cold.

The researchers recruited 152 healthy 18- to 55-year-olds, and measured telomere length in the volunteers' T cells -- immune system cells that fight off infection. They then exposed the men and women to a cold virus via nasal drops, and quarantined them in a hotel to be monitored.

Over the next five days, 22 percent of the volunteers developed cold symptoms, and the odds were higher among those with shorter telomeres in a particular subtype of T cell. Of the one-third with the shortest telomeres, 26 percent became sick, versus 13 percent among the one-third with the longest telomeres.

"This is something new and provocative," said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University School of Medicine in Nashville, Tenn., who was not involved in the research.

"All of us know some people who get one cold after another, and others who seem like they're able to be around people with colds but remain robust," said Schaffner, who is also a spokesman for the Infectious Diseases Society of America.

These findings, Schaffner said, raise the possibility that there is some role for the telomeres in our T cells.

"We're not all created equal in terms of our telomeres," he said. "Just like some of us are short, and some are tall."

What does that mean for you during cold and flu season? Nothing right now, according to both Schaffner and Cohen.

For one, nobody knows if they have skimpy telomeres. And even if they did, it's not clear whether there's anything they could do about it.

"There is a lot of research interest right now in whether it's possible to alter telomere length, either through some kind of behavioral change or a medication," Cohen said. "But we're pretty far from that point."

What's more, the current findings do not prove that shorter telomeres, per se, mean more cold misery. The researchers did account for other factors, such people's age, weight and race. But Cohen said there could be other explanations. It's possible, for example, that some genetic factor makes people have shorter T-cell telomeres and renders them more vulnerable to colds.

On the other hand, shorter telomeres may impair T cells' ability to battle cold viruses, Cohen said.

Still, no one knows yet whether these findings could one day have practical use.

"This is really the first evidence that this biomarker of aging may be important for 25-year-olds as well as 65-year-olds, and for acute health conditions as well as chronic," Cohen said.

Of course, you do not need to wait for any telomere-lengthening therapy to curb your risk of catching a cold. "Wash your hands," Schaffner advised. "And try to avoid people who are sneezing and coughing."

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Sheldon Cohen, Ph.D., professor, psychology, Carnegie Mellon University, Pittsburgh; William Schaffner, M.D., chair, preventive medicine, Vanderbilt University School of Medicine, Nashville, Tenn.; Feb. 20, 2013, Journal of the American Medical Association

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Fluorescent Tracer 'Lights Up' Brain Tumor for Surgery

By Barbara Bronson Gray
HealthDay Reporter

TUESDAY, Feb. 19 (HealthDay News) -- Neurosurgeons report that they harnessed the power of fluorescent light to illuminate a brain tumor so the entire growth could be removed.

A report describes a case in which a patient with glioblastoma swallowed a pill, called 5-ALA, and was taken to surgery about four hours later. The medication attached itself to tumor cells, causing them to glow brightly. Once the skull was opened, the doctors focused a blue light on the tumor, which gave the cancerous cells a pink glow, so the surgeons could differentiate malignant tissue from healthy tissue.

"This is a very, very good thing," said study author Mitchel Berger, chairman of neurosurgery at the University of California, San Francisco. "In this case, we just happened to notice we could see evidence of the tumor spreading along the way of the ventricles [a communicating network of brain cavities], which showed we could see tumor dissemination."

The authors noted that the best way to extend survival is to remove as much of the brain tumor as possible. The research is published in the Feb. 19 issue of the Journal of Neurosurgery.

It's not always easy to see precisely where a tumor has spread in the brain. Some types of tumors can be particularly difficult to identify and remove, even with the benefit of MRI and surgical microscopes.

The use of fluorescence appears to be more effective than MRI technology, at least in this case, because the glow allows surgeons to see microscopic remnants of the tumor and areas of the cancer that might be mistaken for edema, or swelling, Berger explained. "This is an inexpensive way to identify high-grade tumors," he said.

Glioblastomas are a fast-growing type of tumor that usually occurs in adults and affects the brain more often than the spinal cord, according to the U.S. National Cancer Institute.

Why do tumor cells respond differently to the fluorescent drug than the body's other cells do? Their metabolism involves porphyrin, which has a tremendous ability to absorb light, Berger explained. Porphyrin is an organic compound, like the pigment in red blood cells. The pill used in the case report is derived from porphyrin.

The report focused on the case of a 56-year-old man who had undergone resection of a glioblastoma located in the right occipital lobe of his brain in 2005. Several years later, when symptoms reappeared, an MRI scan showed three distinct, new sites of tumor in the patient's right temporal lobe.

In surgery, when the surgeons viewed the fluorescent tumor cells, they could tell rather than being a new tumor, the cancer had spread from its original location on the right side of the brain through a pathway along the wall of the right ventricle. The researchers found that the use of 5-ALA during surgery enabled them to see the actual pathway of the tumor as it had spread.

The use of 5-ALA changed the patient's prognosis. "Multi-centric disease worsens the prognosis," Berger explained.

While the technique has been used in Europe for several years, the U.S. Food and Drug Administration has not approved the use of 5-ALA in the United States. Any surgeons using 5-ALA do so with limited permission from the FDA, Berger noted. The medication, 5-ALA, is manufactured by DUSA Pharmaceuticals.

Dr. Michael Schulder, vice chairman of the department of neurosurgery at North Shore University Hospital in Manhasset, N.Y., explained that "while the FDA considers 5-ALA a drug, which would require a lengthy process for approval, neurosurgeons see it as a surgical aid, which would take far less time to get the OK."

While Schulder said he thinks 5-ALA probably will add about six months to the anticipated survival of patients with high-grade gliomas, he said that attempts to improve the ability to remove these tumors will only go so far. "In the end, however helpful the use of 5-ALA or similar compounds may be in the surgical removal of brain cancers, it won't be the answer. The treatments will have to be biological to truly have an impact on survival, and ultimately, on a cure."

Schulder said he thinks it would be possible for fluorescence to be used in other types of surgeries, if surgeons could become comfortable using a surgical microscope with the benefit of a special light (something neurosurgeons are accustomed to using). He noted that he also thinks the technique might apply to some spinal surgeries, where visualizing the spinal cord is critical.

Schulder said he thinks the use of fluorescence in cancer surgery is promising. "It's a very important concept: if you can see a tumor better, you can remove it without affecting healthy tissue."

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Mitchel Berger, M.D., professor and chairman, neurosurgery, department of neurological surgery, University of California, San Francisco; Michael Schulder, M.D., vice chairman, department of neurosurgery, North Shore University Hospital, Manhasset, N.Y.; Feb. 19, 2013, Journal of Neurosurgery

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